RT Journal Article
SR Electronic
T1 Prognostic factors analysis of patients with acute exacerbation of idiopathic interstitial pneumonias treated by polymyxin B hemoperfusion
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P462
VO 42
IS Suppl 57
A1 Keiji Oishi
A1 Keisuke Aoe
A1 Yoriyuki Murata
A1 Kenji Sakamoto
A1 Takashi Ohfuji
A1 Wataru Kotoku
A1 Yoshiko Ogata
A1 Tsuneo Matsumoto
A1 Hiroshi Ueoka
A1 Yusuke Mimura
YR 2013
UL http://erj.ersjournals.com/content/42/Suppl_57/P462.abstract
AB Background: Acute exacerbations of idiopathic interstitial pneumonias (AE-IIPs) are episodes of acute respiratory worsening with high mortality. Direct hemoperfusion with polymyxin B-immobilized fiber column (PMX-DHP), which was established in Japan for treatment of sepsis, has been shown to improve the respiratory status of patients with ARDS. Recent reports have suggested beneficial effects of PMX-DHP on oxygenation in AE-IIPs as well. Here we aimed to investigate the outcome and prognostic factors in patients with AE-IIPs treated by PMX-DHP.Methods: We retrospectively compared 23 AE-IIP patients treated by steroid pulse therapy and PMX-DHP (PMX-DHP group) with 16 AE-IIP patients by steroid pulse therapy (control group). PMX-DHP was conducted once daily for 6 hours, 2 successive days.Results: The 90-day survival rate was significantly higher in PMX-DHP group (52.2%) than in control group (18.8%). The median survival time was 192 days for PMX-DHP group vs 21.5 days for control group (log rank test P value = 0.0134). Univariate analysis showed that age, duration of AE-IIP till PMX-DHP and P/F ratio were significant predictors of survival. Using multivariate analysis age (p=0.006,HR=19.65) and the duration (p=0.004,HR=22.72) were found to be independent prognostic factors.Conclusion: This case-control study suggests that PMX-DHP therapy improves survival in AE-IIP patients. The prognostic potential of age and duration of AE-IIP may be useful for the selection of patients who benefit from PMX-DHP.